Genetics, calcium intake and osteoporosis
Genetics, calcium intake and osteoporosis
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DOI：
10.1079/pns19980031
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发表时间：
1998-05-01
影响因子：
7
通讯作者：
Eisman, JA
中科院分区：
文献类型：
--
作者：
Eisman, JA
骨质疏松症是世界范围内的一个主要健康问题，尤其是随着年龄的增长，男性和女性都存在骨质疏松症。老年骨骼的强度来自于成年早期获得的骨骼强度，以及与年龄相关的骨质流失，对女性来说，与绝经后相关的骨质流失。虽然外伤和老年人摔倒的方式是导致骨折风险的重要因素，但骨量低是一个主要因素。骨量的决定因素包括外部因素，如生活方式，特别是体力活动和钙的摄入量。各国膳食钙摄入量的巨大差异与骨质疏松性骨折风险无关，这可能是由于人群之间和人群内部的种族差异。双胞胎方法在确定骨密度（和更替）的年龄特异性变异的主要部分方面是有用的，这是由基因决定的。为了探索可能的遗传因素，我们报道了维生素D受体（VDR）基因的常见等位基因变异与骨转换和密度指标相关。随后的研究，包括我们自己的研究，都发现了较弱的影响。然而，VDR基因多态性的等位基因效应现在已经在广泛的范围内报道，但不是全部，白种人和亚洲人群，他们已经研究过。就可能的生理机制而言，VDR等位基因与肠道钙吸收的差异以及骨密度对长期膳食钙摄入的反应有关。此外，已发现对活性维生素D化合物的反应差异与VDR基因等位基因有关。了解这些与基因编码区差异和翻译产物无关的等位基因变异如何改变与饮食操作相关的骨平衡，具有改善骨质疏松症预防和治疗的巨大潜力。此外，它还可以作为遗传多样性与民族和种族群体内部和之间不同营养需求之间相互作用的模型。
Osteoporosis is a major health problem worldwide, particularly with advancing age in both men and women. The strength of the skeleton in older age results from bone strength achieved in early adulthood and age-related and, in women, post-menopause-related bone loss. While trauma and the manner in which older people fall are important contributors to fracture risk, low bone mass is a major factor. Determinants of bone mass include external factors such as lifestyle, especially physical activity, and calcium intake. The wide variation in dietary calcium intake across countries does not correlate with osteoporotic fracture risk, presumably due to ethnic differences between and within populations. The twin approach has been useful in the identification of the major part of age-specific variation in bone density (and turnover), which is genetically determined. Exploring possible genetic factors, we reported that common allelic variations in the vitamin D receptor (VDR) gene were associated with indices of bone turnover and density. Subsequent studies, including our own, have found weaker effects. However, allelic effects of the VDR gene polymorphisms have now been reported in a wide range of, but not all, Caucasian and Asian populations in which they have been studied. In relation to possible physiological mechanisms, the VDR alleles correlate with differences in gut calcium absorption and response of bone density to long-term dietary calcium intake. Moreover, differences in response to active vitamin D compounds have been found in relation to VDR gene alleles. Understanding how these allelic variants, which are not associated with differences in the coding region of the gene and thus the translated product, alter bone homoeostasis in relation to dietary manipulations has great potential to improve osteoporosis prevention and treatment. Also, it can serve as a model of the interaction between genetic diversity and differing nutritional requirements within and between ethnic and racial groups.